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Sunday, September 28, 2008

Ahh, sleep

This morning as I awoke, I rolled over and stretched a lovely long stretch. My first thoughts were “I feel gre-“ but my reverie was interrupted by the sudden realization that I HAD SLEPT ALL NIGHT LONG. I grabbed the on-call phone next to my bed and anxiously scrolled to the “missed calls” file. It was empty. And then I was left with the vaguely guilty feeling that I have far too frequently after having a good night’s sleep.

When did this start? Why do I have a problem with sleeping all night long?

My first recollection of this sensation dates back to when I was an intern almost 20 years ago. A resident I worked with was fond of heading to the on-call room as soon as possible during call nights and jumping into an open bed. His rationale was that any sleep was better than no sleep and 45 minutes of sleep at 7PM might well be the only sleep of the night. I still recall the first night of call when I decided to do the same; I headed to the on-call room and tucked into a lower bunk, optimistically setting the alarm in the room for the next morning. I woke the next morning to the sound of the alarm blaring and immediately wondered why I hadn’t gotten called. I frantically paged myself. When my pager went off, I hung up and did it again. Again, my beeper responded immediately. I found a toothbrush and freshened up as best I could, then headed down to the morning lecture. On the way, I ran across the resident who had been on call with me the night before. He grinned at me guiltily and then said, “You’ll never have another night like this. Savor it. But don’t ever talk about it.” His unspoken comments implied that sleeping during a night of call was frowned upon – even if there were no patients who needed the night intern or resident.

I recall the same sensation the first night both kids slept through the night. My initial drowsiness upon wakening abruptly vanished with the realization that I hadn’t heard the baby cry. Stumbling into the nursery expecting the worst, my fears resolved upon the sight of Eldest earnestly holding a conversation with his stuffed bear; a few years later, it was Youngest’s voice singing aloud which soothed my concern after a similar night.

But I still don’t know why I feel guilty after getting a good night’s sleep. Is it because I spend so much of my time fighting fatigue that I don’t know what to do when the feeling is gone? Have I grown so accustomed to chronic sleepiness from interrupted nights that what should be normal for my brain and body is now considered the aberrant?

Even now, after having been awake for several hours, I feel “off”. Is it extra energy, lack of fatigue, hypercapnia from sleeping with my head under the pillow for an additional ninety minutes?

So MWAS, here's a really long answer to your question of the other day: 7 hours to function, 8+ to feel good (but then I feel bad). Does anyone else have this guilt after sleeping well?

Guilt, no. Panic, yes. I well remember the night second baby slept thru the night. Baby number one (18 months) had taken to waking every am at 3 (teething, I guess) and generally I would take care of her and then number 2 next. Baby one wakes up as usual, I am back in bed when--goood heavens, what about number 2? I was in there every hour until 6, checking to see if she was still breathing......

Mothers in Medicine is a group blog by physician-mothers, writing about the unique challenges and joys of tending to two distinct patient populations, both of whom can be quite demanding. We are on call every. single. day.

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